evolve pharm exam 3

Lithium is used in the treatment of bipolar disorder and what other psychiatric disorders? (Select all that apply.) A.) Alcoholism B.) Bulimia C.) Schizophrenia D.) Hypertension E.) Glucocorticoid-induced psychosis

A.) Alcoholism B.) Bulimia C.) Schizophrenia E.) Glucocorticoid-induced psychosis

The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential? A.) Diazepam [Valium] B.) Triazolam [Halcion] C.) Zolpidem [Ambien] D.) Phenobarbital [Luminal Sodium]

D.) Phenobarbital [Luminal Sodium]

A nurse teaches a patient who takes an MAOI about important dietary restrictions. Which foods will the nurse caution the patient to avoid? A.) Aged cheese and sherry B.) Grapefruit and other citrus juices C.) Coffee, colas, and tea D.) Potato and corn chips

A.) Aged cheese and sherry

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? A.) "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." B.) "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." C.) "The order of drawing up insulin does not matter as long as the insulin is refrigerated." D.) "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."

A.) "Draw up the clear regular insulin first, followed by the cloudy NPH insulin."

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? A.) "Inject this insulin with your first bite of food, because it is very fast acting." B.) "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." C.) "This insulin needs to be mixed with regular insulin to enhance the effects." D.) "To achieve tight glycemic control, this is the only type of insulin you'll need."

A.) "Inject this insulin with your first bite of food, because it is very fast acting."

When teaching the patient and family about clozapine therapy, which statements should the nurse include? (Select all that apply.) A.) "It is important for you to obtain ordered blood tests when taking this medication." B.) "Most patients who take this medication lose weight, so you should increase the number of calories you consume each day." C.) "If you experience increased urination, increased thirst, or increased appetite, contact your healthcare provider." D.) "Inform your healthcare provider if you are taking any medications to control seizures." E.) "Contact your healthcare provider if you experience any unexplained tiredness, shortness of breath, increased respirations, chest pain, or heart palpitations."

A.) "It is important for you to obtain ordered blood tests when taking this medication." C.) "If you experience increased urination, increased thirst, or increased appetite, contact your healthcare provider." D.) "Inform your healthcare provider if you are taking any medications to control seizures."

Which instruction would be inappropriate to include in the teaching plan for a patient being started on carbamazepine [Tegretol]? A.) "Take the medication with a glass of grapefruit juice each morning." B.) "Notify the physician if you are gaining weight or your legs are swollen." C.) "Nausea, vomiting, and indigestion are common side effects of carbamazepine." D.) "Have liver function tests performed on a routine basis."

A.) "Take the medication with a glass of grapefruit juice each morning.

A patient asks the nurse about treatments for post-traumatic stress disorder (PTSD). Which statement by the nurse is the most helpful? A.) "The primary treatment is therapy, but there are some medications that have been somewhat effective." B.) "The primary treatment is monotherapy with an SSRI." C.) "The primary treatment is a combination of multiple medications." D.) "The primary treatment is benzodiazepine for anxiety."

A.) "The primary treatment is therapy, but there are some medications that have been somewhat effective."

The nurse is teaching a patient who has a new prescription for citalopram [Celexa]. Which statement is appropriate to include in the teaching plan? (Select all that apply.) A.) "This medication may cause some sexual side effects. Let your healthcare provider know about this if it occurs." B.) "When you stop taking this medication, you should not withdraw it abruptly." C.) "You will need to move slowly from a sitting to a standing position to prevent dizziness from low blood pressure." D.) "This medication often causes drowsiness. You should take it at bedtime." E.) "Let your family or your healthcare provider know if you experience a worsening mood, agitation, or increased anxiety."

A.) "This medication may cause some sexual side effects. Let your healthcare provider know about this if it occurs." B.) "When you stop taking this medication, you should not withdraw it abruptly. E.) "Let your family or your healthcare provider know if you experience a worsening mood, agitation, or increased anxiety."

The nurse is teaching a patient with a new prescription for alprazolam [Xanax]. Which statement is the most appropriate to include in the teaching plan? A.) "When it is time to discontinue this drug, you will need to taper it off slowly." B.) "Protect your skin from the sun to prevent rash and exaggerated sunburn." C.) "Increase your intake of fluid and high-fiber foods to prevent constipation." D.) "Take this medication on an empty stomach at least 2 hours after meals."

A.) "When it is time to discontinue this drug, you will need to taper it off slowly."

The healthcare provider ordered lorazepam [Ativan] 0.5 mg IV every 6 hours for anxiety. The medication available is lorazepam [Ativan] 2 mg/mL. How many mL will the nurse administer? A.) 0.25 B.) 0.5 C.) 1 D.) 4

A.) 0.25

The nurse knows that which statements about postpartum depression are true? (Select all that apply.) A.) About 80% of women experience depressive symptoms after giving birth. B.) Thyroid insufficiency has been indicated as a contributing factor in postpartum depression. C.) Monoamine oxidase inhibitors are the first-line agents of choice for the treatment of postpartum depression. D.) Once a woman has had postpartum depression, it will not recur with future deliveries. E.) Sertraline [Zoloft] is the drug of choice for treating postpartum depression in breast-feeding mothers. Correct

A.) About 80% of women experience depressive symptoms after giving birth. B.) Thyroid insufficiency has been indicated as a contributing factor in postpartum depression. E.) Sertraline [Zoloft] is the drug of choice for treating postpartum depression in breast-feeding mothers.

When comparing benzodiazepines to barbiturates, the nurse identifies which statements about benzodiazepines as true? (Select all that apply.) A.) Benzodiazepines have a high safety profile. Correct B.) Benzodiazepines have a significant ability to depress central nervous system (CNS) function. C.) Benzodiazepines are associated with a high suicide potential. D.) Benzodiazepines have a low ability to cause tolerance. E.) Benzodiazepines have a low abuse potential.

A.) Benzodiazepines have a high safety profile D.) Benzodiazepines have a low ability to cause tolerance. E.) Benzodiazepines have a low abuse potential.

A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? A.) Blood glucose control for 24 hours B.) Mealtime coverage of blood glucose C.) Less frequent blood glucose monitoring D.) Peak effect achieved in 2 to 4 hours

A.) Blood glucose control for 24 hours

The nurse receives a laboratory report indicating that the phenytoin [Dilantin] level for the patient seen in the clinic yesterday is 16 mcg/mL. Which intervention is most appropriate? A.) Continue as planned, because the level is within normal limits. B.) Tell the patient to hold today's dose and return to the clinic. C.) Consult the prescriber to recommend an increased dose. D.) Have the patient call 911 and meet the patient in the emergency department.

A.) Continue as planned, because the level is within normal limits.

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? A.) Creatinine (Cr) level of 2.1 mg/dL B.) Hemoglobin (Hgb) level of 9.5 gm/dL C.) Sodium (Na) level of 131 mEq/dL D.) Platelet count of 120,000/mm3

A.) Creatinine (Cr) level of 2.1 mg/dL

The selective serotonin reuptake inhibitors (SSRIs) are recommended therapy for a number of psychologic disorders. The nurse identifies the SSRIs as effective for the treatment of patients with which psychologic disorders? (Select all that apply.) A.) Depression B.) Panic disorder C.) Social anxiety disorder D.) Post-traumatic stress disorder E.) Obsessive-compulsive disorder

A.) Depression B.) Panic disorder C.) Social anxiety disorder E.) Obsessive-compulsive disorder

A family member of a patient who is experiencing a severe manic episode asks the nurse why the patient is receiving an antipsychotic medication. The nurse informs the family member that antipsychotics are used in the treatment of severe manic episodes to do what? A.) Help control symptoms during the severe manic episode B.) Elevate mood during the severe manic episode C.) Produce sedating effects during the severe manic episode D.) Reduce the amount of physical pain the patient experiences during the severe manic episode

A.) Help control symptoms during the severe manic episode

Which statement about aripiprazole would the nurse identify as true? A.) It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers. B.) It must be administered on an empty stomach. C.) Gynecomastia is a common adverse effect. D.) It is safe to use in older adult patients with dementia-related psychosis.

A.) It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers.

Which drug should be used with caution in a patient with first-degree atrioventricular (AV) heart block? A.)Lacosamide [Vimpat] B.)Felbamate [Felbatol] C.)Tiagabine [Gabitril] D.)Levetiracetam [Keppra]

A.) Lacosamide [Vimpat]

Which statements about the treatment of bipolar disorder does the nurse identify as true? (Select all that apply.) A.) Mood stabilizers are used to prevent recurrent manic-depressive episodes. B.) Antipsychotics are used to treat depressive episodes. C.) Antidepressants should be used with mood stabilizers in the treatment of patients with bipolar depression. D.) Lithium and valproate are the preferred mood stabilizers for BPD. E.) A lithium level of 2.0 mEq/L is considered therapeutic.

A.) Mood stabilizers are used to prevent recurrent manic-depressive episodes C.) Antidepressants should be used with mood stabilizers in the treatment of patients with bipolar depression. D.) Lithium and valproate are the preferred mood stabilizers for BPD.

The nurse is caring for a patient with a seizure disorder who takes phenobarbital at bedtime each night to control seizures. Which symptom, if present, would most likely indicate an adverse effect of this drug? A.) Morning sedation B.) A respiratory rate of 30 breaths per minute C.) Constipation D.) A blood pressure of 160/88 mm Hg

A.) Morning sedation

A distraught patient is admitted to the emergency department with symptoms of palpitations, tachycardia, chest pain, and shortness of breath. The physical examination reveals no physiologic basis for the symptoms. Which diagnosis therefore is most likely? A.) Panic disorder B.) Bipolar disorder C.) Generalized anxiety disorder D.) Clinical depression

A.) Panic disorder

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? A.) Refer the patient to a diabetes educator because the result reflects poor glycemic control. B.) Glycemic control is adequate; no changes are needed. C.) Hypoglycemia is a risk; teach the patient the symptoms. D.) Instruct the patient to limit activity and weekly exercise.

A.) Refer the patient to a diabetes educator because the result reflects poor glycemic control

The nurse is caring for a patient receiving fluoxetine [Prozac] for depression. Which adverse effect is most likely associated with this drug? A.) Sexual dysfunction B.) Dry mouth C.) Orthostatic hypotension D.) Bradycardia

A.) Sexual dysfunction

The nurse is caring for a patient with bipolar disorder (BPD) who is taking lithium [Lithobid]. Which abnormal laboratory value is most essential for the nurse to communicate to the healthcare provider because this patient is taking lithium? A.) Sodium level of 128 mEq/L B.) Prothrombin time of 8 seconds C.) Blood urea nitrogen level of 25 mg/dL D.) Potassium level of 5.6 mEq/L

A.) Sodium level of 128 mEq/L

The nurse is caring for a patient receiving phenytoin [Dilantin] for treatment of tonic-clonic seizures. Which symptoms, if present, would indicate an adverse effect of this drug? (Select all that apply.) A.) Swollen, tender gums B.) Measles-like rash C.) Productive cough D.) Unusual hair growth E.) Nausea and vomiting

A.) Swollen, tender gums B.) Measles-like rash D.) Unusual hair growth

The nurse is caring for a group of patients being treated for depression. Why might an SSRI be chosen over a TCA? A.) To reduce the risk of suicide with overdose B.) To avoid weight gain and other gastrointestinal (GI) effects C.) To help prevent sexual dysfunction D.) To prevent the risk of serotonin syndrome

A.) To reduce the risk of suicide with overdose

The nurse is caring for a patient with depression who takes citalopram [Celexa], an antidepressant. The nurse understands that the full therapeutic effects are not seen until about 3 to 4 weeks after beginning this drug. What is the best description of this process? A.)Adaptive changes in the brain B.)Drug tolerance and dependence C.)A wide therapeutic index D.) Improved neuronal transmission

A.) adaptive changes in the brain

Which medication can be used to manage fatigue associated with multiple sclerosis? (Select all that apply.) A.) Modafinil [Provigil] B.) Clonazepam [Klonopin] C.) Amantadine [Symmetrel] D.) Carbamazepine [Tegretol] E.) Dalfampridine [Ampyra]

A.) modafinil C.) Amantadine

Which neurotransmitter is active in both the peripheral and central nervous systems (CNS)? A.)Norepinephrine B.)Serotonin C.)Substance P D.0Dynorphins

A.) norepinephrine

The nurse is working with a group of patients receiving drugs that work in the central nervous system (CNS). Nursing care of these patients is based on which facts? (Select all that apply.) A.)Overall knowledge of the workings of CNS agents is limited. B.)The CNS has many more neurotransmitters than the periphery. C.)Animal studies in progress will greatly enhance knowledge of CNS medications. D.)When CNS drugs are taken long term, their effects differ from initial use. E.)The blood-brain barrier is permeable to water-soluble drugs.

A.) overall knowledge of the workings of CNS agents is limited B.) the CNS has many more neurotransmitters than the periphery D.) when CNS drugs are taken long term, their effects differ from initial use

A patient has elected to use rasagiline as a monotherapy treatment for PD. Which teaching statement by the nurse is incorrect? A.)"Rasagiline may cause insomnia, so monitor your sleeping habits." B.)"It is important to avoid tyramine-containing foods." C.)"You may be at increased risk for malignant melanoma, so have regular skin checks." D.)"You may experience side effects, such as headache, arthralgia, dyspepsia, depression, and flu-like symptoms."

A.) rasigline may cause insomnia, s monitor your sleeping habits

The nurse is conducting discharge teaching related to a new prescription for phenytoin [Dilantin]. Which statements are appropriate to include in the teaching for this patient and family? (Select all that apply.) A.) "Be sure to call the clinic if you or your family notice increased anxiety or agitation." B.) "You may have some mild sedation. Do not drive until you know how this drug will affect you." C.) "This drug may cause easy bruising. If you notice this, call the clinic immediately." D.) "It is very important to have good oral hygiene and to visit your dentist regularly." E.) "You may continue to have wine with your evening meals, but only in moderation."

A.)"Be sure to call the clinic if you or your family notice increased anxiety or agitation. B.)"You may have some mild sedation. Do not drive until you know how this drug will affect you." D.) "It is very important to have good oral hygiene and to visit your dentist regularly."

The nurse is caring for a patient receiving clozapine [Clozaril]. Which assessment finding is most indicative of an adverse effect of this drug? A.) Blood urea nitrogen level of 25 mg/dL B.) Blood glucose level of 60 mg/dL C.) Bilirubin level of 2.5 mg/dL D.) White blood cell (WBC) count of 2000/mm3

D.) White blood cell (WBC) count of 2000/mm3

Which statement does the nurse include when teaching a patient about antipsychotic drug therapy? (Select all that apply.) A.) "Restrict the use of antipsychotic drugs to 3 months to prevent the development of addiction." B.) "Dilute oral preparations in fruit juice to improve their palatability." C.) "Store oral preparations in a dark area." D.) "Do not make skin contact with these drugs; flush the affected area with water if a spill occurs." E.) "Take an over-the-counter sleep aid if you have trouble falling asleep at night."

B.) "Dilute oral preparations in fruit juice to improve their palatability." C.) "Store oral preparations in a dark area. D.) "Do not make skin contact with these drugs; flush the affected area with water if a spill occurs."

Which statement made by a female patient newly diagnosed with complex partial seizures and starting treatment with valproic acid indicates a need for further teaching by the nurse? A.) "The medication should not make me feel sleepy." B.) "I should take the medication on an empty stomach." C.) "I'll need to discuss a reliable form of birth control with my gynecologist." D.) "I'll call my physician immediately if I develop a yellow tint to my skin or my urine appears tea-colored."

B.) "I should take the medication on an empty stomach."

Which instruction does the nurse include when teaching a patient about phenelzine [Nardil] therapy? (Select all that apply.) A.) "Take the medication as needed when you are feeling depressed." B.) "If you experience a severe headache, inform your healthcare provider." C.) "Profuse sweating is an expected side effect of this medication and will diminish with time." D.) "Ginseng can be used to treat headache, which patients often experience when they first take phenelzine." E.)"Avoid eating avocados when taking this drug."

B.) "If you experience a severe headache, inform your healthcare provider." E.)"Avoid eating avocados when taking this drug."

A nurse is caring for several patients. In which patient is it appropriate to use the drug chlorpromazine [Thorazine]? (Select all that apply.) A.) An 85-year-old man with Alzheimer's disease B.) A 78-year-old man with intractable hiccups C.) A 76-year-old woman with severe dementia D.) A 48-year-old woman with schizoaffective disorder E.) A 30-year-old man with anxiety and depression

B.) A 78-year-old man with intractable hiccups D.) A 48-year-old woman with schizoaffective disorder

The nurse is seeing several patients in the outpatient clinic today. Which patient most requires the nurse's immediate attention? A.) A female patient with BPD who takes valproic acid [Depakene] and who reports nausea and vomiting B.) A male patient with BPD who takes lithium and who has a lithium level of 1.6 mEq/L C.) A male patient with depression who takes fluoxetine [Prozac] and who reports sexual dysfunction D.) A female patient with schizophrenia who takes haloperidol [Haldol] and who has a blood pressure of 102/72 mm Hg

B.) A male patient with BPD who takes lithium and who has a lithium level of 1.6 mEq/L

The nurse is preparing to give ethosuximide [Zarontin]. The nurse understands that this drug is only indicated for which seizure type? A.) Tonic-clonic B.) Absence C.) Simple partial D.) Complex partial

B.) Absence

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) A.) Type 2 diabetes B.) Altered fat metabolism leading to ketones C.) Arterial blood pH of 7.35 to 7.45 D.) Sudden onset, triggered by acute illness E.) Plasma osmolality of 300 to 320 mOsm/L

B.) Altered fat metabolism leading to ketones D.) Sudden onset, triggered by acute illness E.) Plasma osmolality of 300 to 320 mOsm/L

A patient with Parkinson's disease who takes levodopa/carbidopa [Sinemet] comes to the clinic for a semiannual physical examination. Which question is the most important for the nurse to ask? A.)"Have you noticed any swelling in your feet?" B.)"Are you having vivid dreams or hallucinations?" C.)"Have you noticed any changes in your stool?" D.) "Have you had your flu vaccine?"

B.) Are you having vivid dreams or hallucinations

The nurse is caring for a patient hospitalized with an acute episode (relapse) of MS. Which agent is the preferred treatment during relapse? A.) Interferon beta-1a [Avonex] IM B.) Methylprednisolone [Solu-Medrol] IV C.) Glatiramer acetate [Copaxone] subQ D.) Natalizumab [Tysabri] IV infusion

B.) Methylprednisolone (Solu-Medrol) IV

he nurse is working with the multidisciplinary healthcare team to optimize the care of a patient with schizophrenia. Which concepts will guide the nursing care of this patient? (Select all that apply.) A.) The second-generation antipsychotics generally are more effective than the first-generation agents. B.) Most antipsychotic agents increase the risk of mortality in elderly patients with dementia. Correct C.) Antipsychotic depot preparations carry a greater risk of neuroleptic malignant syndrome. D.) The lipid levels of patients receiving second-generation antipsychotics should be monitored. E.) Schizophrenia is characterized by disordered thinking and loss of touch with reality.

B.) Most antipsychotic agents increase the risk of mortality in elderly patients with dementia D.) The lipid levels of patients receiving second-generation antipsychotics should be monitored. E.) Schizophrenia is characterized by disordered thinking and loss of touch with reality.

Which medication used for the management of multiple sclerosis cannot be self-administered? A.) Fingolimod [Gilenya] B.) Natalizumab [Tysabri] C.) Glatiramer acetate [Copaxone] D.) Interferon beta-1b [Betaseron]

B.) Natalizumab

The nurse identifies which most common serious adverse effect of TCA therapy? A.) Excitation B.) Orthostatic hypotension C.) Skin rash D.) Sexual dysfunction

B.) Orthostatic hypotension

A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? A.) Inhibition of carbohydrate digestion B.) Promotion of insulin secretion C.) Decreased insulin resistance D.) Inhibition of ketone formation

B.) Promotion of insulin secretion

The nurse is caring for a patient in the emergency department who reports the onset of agitation, confusion, muscle twitching, diaphoresis, and fever about 12 hours after beginning a new prescription for escitalopram [Lexapro]. Which is the most likely explanation for these symptoms? A.) Depressive psychosis B.) Serotonin syndrome C.) Escitalopram overdose D.) Cholinergic crisis

B.) Serotonin syndrome

The healthcare provider ordered lamotrigine [Lamictal] for long-term maintenance therapy of BPD. The nurse anticipates which dosing schedule? A.) Starting at a high dose to quickly control mania B.) Starting at a low dose and titrating up C.) Starting at a high dose and titrating down D.) Starting with a loading dose and then a low maintenance dose

B.) Starting at a low dose and titrating up

A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? A.) Skin rash B.) Sweating C.) Itching D.)Pedal edema

B.) Sweating

The nurse has just administered the first dose of haloperidol [Haldol] to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider before administering the next dose of medication? A.) Dry mouth B.) Temperature of 101°F C.) BP of 104/72 mm Hg D.) Drowsiness

B.) Temperature of 101°F

The nurse suspects that a female patient is experiencing phenytoin toxicity if which manifestation is noted? (Select all that apply.) A.) The patient complains of excessive facial hair growth. B.) The patient is walking with a staggering gait. C.) The patient's gums are swollen, tender, and bleed easily. D.) The patient complains of double vision. E.) The nurse observes rapid back-and-forth movement of the patient's eyes.

B.) The patient is walking with a staggering gait. D.) The patient complains of double vision. E.) The nurse observes rapid back-and-forth movement of the patient's eyes.

The nurse identifies which antidepressant as effective in the treatment of generalized anxiety disorder (GAD)? (Select all that apply.) A.) Fluoxetine [Prozac] B.) Venlafaxine [Effexor XR] C.) Paroxetine [Paxil] D.) Escitalopram [Lexapro] E.) Duloxetine [Cymbalta]

B.) Venlafaxine [Effexor XR] C.) Paroxetine [Paxil] D.) Escitalopram [Lexapro] E.) Duloxetine [Cymbalta]

The nurse is caring for a patient whose seizures are characterized by a 10- to 30-second loss of consciousness and mild, symmetric eye blinking. Which seizure type does this most closely illustrate? A.) Tonic-clonic B.) Absence C.) Atonic D.) Myoclonic

B.) absence

The nurse is reviewing the care of patients with AD. Which factors are associated with the pathophysiology of this disease? (Select all that apply.) A.)Dilation and inflammation of cranial blood vessels B.) Beta-amyloid and neuritic plaques Correct C.)Neurofibrillary tangles and tau Correct D.)Autoimmune changes in the myelin sheath E.) Firing of hyperexcitable neurons throughout the brain F.) Neuronal degeneration and decreased acetylcholine

B.) beta-amyloid and neurotic plaques C.) neurofibrillary tangles and tau F.) neuronal degeneration and decreased acetylcholine

Which statement should the nurse include in the teaching plan for a patient being started on levodopa/carbidopa [Sinemet] for newly diagnosed Parkinson's disease? A.)Take the medication on a full stomach. B.)Change positions slowly. C.)The drug may cause the urine to be very dilute. D.)Carbidopa has many adverse effects.

B.) change positions slowly

A patient with Parkinson's disease is prescribed pramipexole [Mirapex] along with his levodopa/carbidopa [Sinemet]. Which symptom is most likely a manifestation of an adverse effect of these drugs when given together? A.)Diarrhea B.)Dyskinesia C.)Wheezing D.)Headache

B.) dyskinesia

A patient with a history of numbness, weakness, and blurred vision recently was diagnosed with multiple sclerosis (MS). What does the nurse understand to be the underlying pathophysiology for these symptoms? A.) An imbalance of dopamine and acetylcholine in the central nervous system B.) Inflammation and myelin destruction in the central nervous system C.) An inability of serotonin to bind to its receptors in the chemoreceptor trigger zone D.) High-frequency discharge of neurons from a specific focus area of the brain

B.) inflammation and myelin destruction in the central nervous system

The nurse is teaching a patient newly diagnosed with epilepsy about her disease. Which statement made by the nurse best describes the goals of therapy with antiepilepsy medication? A.) "With proper treatment, we can completely eliminate your seizures." B.) "Our goal is to reduce your seizures to an extent that helps you live a normal life." C.) "Epilepsy medication does not reduce seizures in most patients." D.) "These drugs will help control your seizures until you have surgery."

B.) our goal is to reduce your seizures to an extent that helps you live a normal life

Which cholinesterase inhibitor has the highest incidence of adverse gastrointestinal (GI) effects? A.)Donepezil [Aricept] B.)Rivastigmine [Exelon] C.)Galantamine [Reminyl] D.))Memantine [NMDA]

B.) rivastigmine (Exelon)

The nurse is caring for a patient with MS who is having worsening recurrent episodes of neurologic dysfunction followed by periods of partial recovery. How would this subtype be classified? A.)Relapsing-remitting B.)Secondary progressive C.)Primary progressive D.) Progressive-relapsing

B.) secondary progressive

The nurse is preparing a discharge teaching plan for a patient prescribed phenobarbital to control seizures. Which side effect is expected to occur during initiation of phenobarbital drug therapy but decline once dosage is achieved to control seizures? A.)Nausea B.)Sedation C.)Fatigue D.)Dry mouth

B.) sedation

The nurse is caring for a patient taking buspirone [BuSpar]. Which statement by the patient indicates a need for further teaching about this drug? A.) "This medication should not make me feel drowsy." B.) "This medication should help me feel less anxious." C.) "I will drink grapefruit juice instead of coffee with breakfast." D.) "I will take my medication three times per day."

C.) "I will drink grapefruit juice instead of coffee with breakfast."

A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects? A.) "I'll have to isolate myself from my family so I don't expose them to radiation." B.) "I'm looking forward to feeling better immediately after this treatment." C.) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." D.) "I'll need to take this drug on a daily basis for at least 1 year."

C.) "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."

The healthcare provider ordered lithium 250 mg PO every 8 hours for a patient experiencing acute mania. What will the patient's total dose be in 24 hours? A.) 250 mg B.) 500 mg C.) 750 mg D.) 1000 mg

C.) 750 mg

The nurse is caring for a patient taking lithium [Lithobid]. The nurse understands that many drugs interact with lithium. Which agent is safe to administer with lithium? A.) Ibuprofen [Motrin] for muscle pain B.) Hydrochlorothiazide (HCTZ) for edema C.) Aspirin (ASA) for mild headache D.) Diphenhydramine [Benadryl] for cold symptoms

C.) Aspirin (ASA) for mild headache

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? A.) Take the patient's blood pressure. B.) Give the patient's PRN dose of insulin. C.) Check the patient's capillary blood sugar. D.) Advise the patient to lie down with the legs elevated.

C.) Check the patient's capillary blood sugar.

The nurse identifies which drugs as the principal mood stabilizers used in the treatment of bipolar disorder? (Select all that apply.) A.) Lithium Correct B.) Risperidone C.) Divalproex sodium [Depakote] D.) Carbamazepine Correct E.) Venlafaxine [Effexor]

C.) Divalproex sodium [Depakote]

The nurse is caring for a patient receiving buspirone [BuSpar] for the treatment of anxiety. Which symptom is most likely explained as an adverse effect of this drug? A.) Diarrhea B.) Risk for abuse C.) Dizziness D.) Weight gain

C.) Dizziness

Which drug does the nurse identify as a selective serotonin reuptake inhibitor? (Select all that apply.) A.) Bupropion [Wellbutrin] B.) Imipramine [Tofranil] C.) Fluoxetine [Prozac] D.) Desvenlafaxine [Pristiq] E.) Sertraline [Zoloft]

C.) Fluoxetine [Prozac E.) Sertraline [Zoloft]

Which medication should the nurse anticipate administering to a patient in convulsive status epilepticus to halt seizure activity? A.)Phenytoin [Dilantin] 200 mg IV over 4 minutes B.)Phenobarbital 30 mg IM C.) Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min D.) Valproic acid [Depacon] 250 mg in 100 mL of normal saline infused IV over 60 minutes

C.) Lorazepam [Ativan] 0.1 mg/kg IV at a rate of 2 mg/min

Which statement about memantine [Namenda] is false? A.)Memantine is indicated for moderate or severe AD. B.)Memantine modulates the effects of glutamate. C.)Memantine does not slow the decline in function. D.)The most common side effects are dizziness, headache, confusion, and constipation.

C.) Memantine does not slow the decline in function

The nurse is preparing to administer the aripiprazole extended-release 400-mg injection. The nurse is aware that this medication is scheduled to be given how often? A.) Daily B.) Weekly C.) Monthly D.) As needed

C.) Monthly

The nurse is assessing a patient receiving valproic acid [Depakene] for potential adverse effects associated with this drug. What is the most common problem with this drug? A.) Increased risk of infection B.) Reddened, swollen gums C.) Nausea, vomiting, and indigestion D.)Central nervous system depression

C.) Nausea, vomiting, and indigestion

A patient has been diagnosed with performance anxiety. The nurse anticipates use of which drug to treat this psychologic disorder? A.) Clonazepam [Klonopin] B.) Alprazolam [Xanax] C.) Propranolol [Inderal] D.) Sertraline [Zoloft]

C.) Propranolol [Inderal]

The nurse is planning care for a patient taking imipramine [Tofranil]. Which finding, if present, would most likely be an adverse effect of this drug? A.) Blood pressure of 160/90 mm Hg B.) Insomnia and diarrhea C.) Sedation and dry mouth D.) Tachypnea and wheezing

C.) Sedation and dry mouth

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? A.) Vomiting B.) Muscle cramps C.) Tachycardia D.) Chills

C.) Tachycardia

A patient newly diagnosed with MS asks the nurse how a person gets this disease. Which response by the nurse is most accurate and appropriate? A.) "Multiple sclerosis is a congenital condition that typically manifests itself in late adulthood." B.) "Multiple sclerosis is a disease believed to be caused by exposure to drugs during a mother's pregnancy." C.) "This is an autoimmune disease that occurs in people with certain genetic traits when they are exposed to some environmental trigger factor." D.) "This disease is most often caused by an increase of rapidly dividing cells in the central nervous system."

C.) This is an autoimmune disease that occurs in people with certain genetic traits when they are exposed to some environmental trigger factor

Which agent is most likely to be prescribed today for short-term management of insomnia? A.) Secobarbital [Seconal Sodium] B.) Meprobamate [Miltown] C.) Zolpidem [Ambien] D.) Flumazenil [Romazicon]

C.) Zolpidem [Ambien]

The nurse is caring for a group of patients diagnosed with Alzheimer's disease (AD). Which neurotransmitter level is decreased by as much as 90% in patients with severe AD? A.)Norepinephrine B.)Serotonin C.)Acetylcholine D.)Dopamine

C.) acetylcholine

The nurse is working with a student in the care of a patient with AD. Which statement by the student demonstrates an understanding of the cholinesterase inhibitor medications used for AD? A.) "There are four cholinesterase inhibitor medications available to treat AD. They are galantamine, rivastigmine, donepezil, and memantine." B.) "Cholinesterase inhibitors are very effective in treating AD." C.) "Cholinesterase inhibitors do not cure AD or slow the progression of the disease." D.) "All of the cholinesterase inhibitors cause reversible inhibition of AChE."

C.) cholinsterase inhibitors do not cure AD or slow the progression of the disease

A patient with a history of Parkinson's disease treated with selegiline [Eldepryl] has returned from the operating room after an open reduction of the femur. Which physician order should the nurse question? A.)Decaffeinated tea, gelatin cubes, and ginger ale when alert B.)Docusate 100 mg orally daily C.)Meperidine 50 mg IM every 4 hours as needed for pain D.)Acetaminophen 650 mg every 6 hours as needed for temperature

C.) meperidine 50mg IM every 4 hours as needed for pain

A patient with Parkinson's disease who has been positively responding to drug treatment with levodopa/carbidopa [Sinemet] suddenly develops a relapse of symptoms. Which explanation by the nurse is appropriate? A.) "You have apparently developed resistance to your current medication and will have to change to another drug." B.) "This is an atypical response. Unfortunately, there are no other options of drug therapy to treat your disease." C.)"This is called the 'on-off' phenomenon. Your healthcare provider can change your medication regimen to help diminish this effect." Correct D.)"You should try to keep taking your medication at the current dose. These effects will go away with time."

C.) this is called the "on-off" phenomenon. your healthcare provider can change your medication regimen to help diminish this effect

What is the goal of pharmacologic therapy in the treatment of Parkinson's disease? A.)To increase the amount of acetylcholine at the presynaptic neurons B.)To reduce the amount of dopamine available in the substantia nigra C.) To balance cholinergic and dopaminergic activity in the brain D.) To block dopamine receptors in presynaptic and postsynaptic neurons

C.) to balance cholinergic and dopaminergic activity in the brain

The nurse is preparing to administer phenelzine [Nardil] to a patient with depression. Why is this drug considered a second- or third-line agent in the treatment of depression? A.) It increases the risk of suicide in the early phase. B.) It is less effective than the tricyclic antidepressants. C.) It increases the risk of psychoses and parkinsonism. D.) It has more side effects and drug interactions.

D.) It has more side effects and drug interactions.

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? A.) It stimulates the pancreas to reabsorb glucose. B.) It promotes the synthesis of amino acids into glucose. C.) It stimulates the liver to convert glycogen to glucose. D.) It promotes the passage of glucose into cells for energy.

D.) It promotes the passage of glucose into cells for energy.

The nurse is monitoring a patient with depression in the early phase of treatment with amitriptyline [Elavil]. Which question is most important for the nurse to ask the patient? A.) "Have you noticed dry mouth or blurred vision?" B.) "Have you had any changes in your urine function?" C.) "When was your last bowel movement?" D.) "Have you had any changes in your mood or anxiety level?"

D.) "Have you had any changes in your mood or anxiety level?"

A nurse assesses a patient receiving haloperidol [Haldol]. The nurse notices that the patient is shifting in the chair, rocking back and forth, and tapping both feet constantly. What is the most accurate term to document these findings? A.) Dystonia B.) Tardive dyskinesia C.) Parkinsonism D.) Akathisia

D.) Akathisia

The nurse is caring for a patient with severe generalized anxiety disorder. Which agent would be most effective for immediate stabilization? A.) Venlafaxine [Effexor] B.) Buspirone [BuSpar] C.) Paroxetine [Paxil] D.) Alprazolam [Xanax]

D.) Alprazolam [Xanax]

A family member asks the nurse about amantadine. Which statement by the nurse is the most helpful in explaining the use of amantadine? A.) "Amantadine was developed as an antiviral agent but is now used for treatment of PD." B.) "Amantadine works slowly over time but can lose its effectiveness in 3 to 6 months." C.) "Amantadine works rapidly and does not lose its effectiveness." D.)"Amantadine is not as effective as some other medications, so it is not a first-line treatment, but it may be used in addition to other medications."

D.) Amantadine is not as effective as some other medications, so it is not a first-line treatment, but it may be used in addition to other medications

A nurse assesses a patient who takes a maintenance dose of lithium carbonate [Lithobid] for bipolar disorder. The patient complains of hand tremor, nausea, vomiting, and diarrhea. The patient's gait is unsteady. The patient most likely has done what? A.) Consumed some foods high in tyramine B.) Not taken the lithium as directed C.) Developed tolerance to the lithium D.) Developed lithium toxicity

D.) Developed lithium toxicity

A female patient who is originally from Thailand is seen in the clinic for seizure control. She receives a new prescription for carbamazepine [Tegretol]. Before the patient takes the drug, which is the most appropriate initial nursing intervention? A.) Warn her not to withdraw this drug abruptly. B.) Recommend that she take this medication at bedtime with meals. C.) Teach her family to assist with maintaining a seizure frequency chart. D.) Ensure that genetic testing for HLA-B*1502 is performed.

D.) Ensure that genetic testing for HLA-B*1502 is performed.

Alprazolam [Xanax] is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter? A.) Norepinephrine B.) Acetylcholine C.) Serotonin (5-HT) D.) Gamma-aminobutyric acid (GABA)

D.) Gamma-aminobutyric acid (GABA)

Which statements about zaleplon [Sonata] does the nurse identify as true? (Select all that apply.) A.) Zaleplon [Sonata] is a benzodiazepine. B.) Zaleplon [Sonata] is indicated for long-term management of insomnia. C.) Zaleplon [Sonata] is used to maintain sleep throughout the night. D.) Zaleplon [Sonata] should not be administered with cimetidine [Tagamet]. E.) Zaleplon [Sonata] interacts with the neurotransmitter GABA.

D.) Zaleplon [Sonata] should not be administered with cimetidine [Tagamet]. E.) Zaleplon [Sonata] interacts with the neurotransmitter GABA.

The nurse is caring for a patient receiving glatiramer acetate [Copaxone] for MS. Which finding, if present in this patient, could be considered a potential adverse effect of this drug? A.)Flulike symptoms with fever B.)Decreased neutrophil count C.) Jaundice and elevated bilirubin D.) Injection site pain and redness

D.) injection site pain and redness

Which medication can cause this acid-base disturbance: pH 7.32, paCO2 33, HCO3 20? A.)Primidone [Mysoline] B.)Lamotrigine [Lamictal] C.)Lacosamide [Vimpat] D.)Topiramate [Topamax]

D.)Topiramate [Topamax]

The nurse is caring for a patient with insomnia. The patient asks if there are medications for sleep that are not controlled substances. Which statement by the nurse is correct? a.) "Yes, there is a medication that works with your body's melatonin and is not a controlled substance." b.) "No, all of the sleep medications are controlled substances." c.) "There are some over-the-counter medications, and you can take those without discussing them with your healthcare provider." d.) "Yes, but it is not for chronic insomnia."

a.) "Yes, there is a medication that works with your body's melatonin and is not a controlled substance."

A patient has an infection affecting a central nervous system (CNS) component. Which structure makes the delivery of antibiotic therapy more difficult? a.)Blood-brain barrier b.)Chemotherapeutic trigger zone c.)Neuropeptide receptors d.)Thalamic synapses

a.) blood brain barrier

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam? a.) Naloxone [Narcan] b.) Flumazenil [Romazicon] c.) Acetylcysteine [Mucomyst] d.) Vitamin K

b.) Flumazenil [Romazicon]